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Abstract

To the editor: A recent article on methicillin-resistant Staphylococcus aureus endocarditis by Levine and associates (1) suggested that combination therapy with rifampin and vancomycin should be used with caution, in part because of the in-vitro antagonism which has been noted between the two drugs (2, 3). We report a case of methicillin-resistant S. aureus endocarditis in which in-vitro antagonism was present, but in which an apparent bacteriologic cure was obtained only after therapy with both rifampin and vancomycin.

A 73-year-old man with a prosthetic aortic valve became febrile (103.6 °F) 24 hours after a transurethral resection (for which he had